Provider Demographics
NPI:1700835964
Name:HARTOPHILIS, RUSSELL (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:RUSSELL
Middle Name:
Last Name:HARTOPHILIS
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 AVENUE OF THE AMERICAS
Mailing Address - Street 2:CONCOURSE LEVEL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10020-1001
Mailing Address - Country:US
Mailing Address - Phone:646-562-0617
Mailing Address - Fax:212-302-1106
Practice Address - Street 1:1221 AVENUE OF THE AMERICAS
Practice Address - Street 2:CONCOURSE LEVEL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10020-1001
Practice Address - Country:US
Practice Address - Phone:646-562-0617
Practice Address - Fax:212-302-1106
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009409225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist